Archived: WDP Havering

Updated 27 April 2020

WDP Havering provides a drug and alcohol service for adults in the London Borough of Havering. The service provides information and advice, substitute prescribing, community detoxification, blood borne virus screening and vaccination, a group programme and psychosocial interventions. WDP Havering have been operating the service since 2015.

The service had 583 clients on their caseload at the time of the inspection. The service was provided at the registered address and at the recovery hub which was located in the same street. The service was open weekdays, including two evenings until 8.30pm. The service was also open on Saturday mornings.

The service is registered to provide the regulated activity of treatment of disease, disorder or injury.

There was a registered manager in post at the time of the inspection.

We have inspected WDP Havering once. Our last inspection was in November 2016. We did not rate independent substance misuse services at that time.

Following that inspection we issued three requirement notices concerning the following regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014:

Regulation 12 – safe care and treatment

Regulation 17 – good governance

Regulation 18 – staffing

The requirement notices concerned poor risk assessments of clients, lack of contact with clients’ GPs, poor management of medicines and prescriptions for controlled drugs, a lack of staff, lack of supervision of staff, staff not undertaking mandatory training, and no effective system for learning from incidents or dealing with complaints. These matters were resolved at this inspection.

Updated 27 April 2020

We rated WDP Havering as good because:

• The service provided safe, effective and high quality care. Staff consistently followed best practice concerning clients’ substance misuse treatment.

• There were monthly staff meetings focused on discussing clients with safeguarding risks. The safeguarding lead had undertaken audits, resulting in staff consistently undertaking a home visit for clients with young children to assess the safe storage of prescribed medicines. The process for monitoring and auditing safeguarding referrals and actions enhanced the safety of clients and others.

• The outcome of a mortality review was fed back to the local authority commissioners and the local public health team concerning the increase in older adults using the service. Managers were working with partners to identify ways to enhance clients’ care, including end of life care.

• Managers had recognised that clients’ access to Improving Access to Psychological Therapies was dependant on them being abstinent from substances for three months. They had arranged for a worker from that service to attend the service two days per week. If a client was in treatment at the service the three-month rule was waived.

• Leaders in the service had high levels of experience, capacity and capability to deliver high quality treatment and care. They provided compassionate, effective and inclusive leadership of the service and had developed a culture of openness, transparency and continuous improvement.

• The views of clients and families and carers were viewed as essential to the operation of, and developments in, the service. Groups for clients and families and carers were open and leaders in the service welcomed constructive challenge. Decisions regarding the service were made transparently with clients. If a new idea could not be developed, there was an explanation, and encouragement to identify an alternative.

• Individual staff members and service user representatives were the joint leads for specific areas of the service. They worked collaboratively to problem-solve and develop the service in those areas. This included areas not usually associated with client involvement, such as safeguarding.

• Staff described a respectful, supportive culture where they felt valued and motivated to provide high quality care and treatment. Staff were empowered to carry out their roles and there was a strong focus on career development. Staff were very positive concerning the leadership team and were proud to work for the provider.

• The service had an integrated governance system which provided effective and accurate monitoring and assurance of risks, issues and performance in the service. There were governance processes for all areas of practice. Leaders addressed areas for improvement with staff quickly and effectively.

• Leaders worked systematically, proactively and effectively with partners. The service led on identifying changes in the local population who misused substances and identifying areas of unmet need. This had included access to psychological therapies, the homeless population and the increasing number of older adult clients.

• Staff had access to the information they needed to provide safe and effective care and used that information to good effect. Managers had accurate information to monitor the performance of the service. There was a comprehensive governance system.

However:

• Although all clients’ risk assessments documented potential risks, the full context of those risk was not always described. Leaders had identified this and there were plans to hold workshops after the inspection.

• A minority of clients’ care plans were generic. Whilst they addressed clients’ needs, they were not personalised or holistic. This had been identified and workshops were due to take place.

Updated 27 April 2020